| NPI | 1174948004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA OS024552) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 5101026082) |
| Enumeration Date | 2014-03-01 |
| Last Update Date | 2025-02-06 |