| NPI | 1215433206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A200643) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 29184) |
| 207T00000X Neurological Surgery (Licence: MN 65896) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2025-07-24 |