| NPI | 1205271525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN 64025) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO CDR.0004787) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2026-07-23 |