| NPI | 1184075996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME181601) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 078276) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2026-06-19 |