| NPI | 1255548418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T0601) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A109384) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2026-08-12 |