| NPI | 1255562054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VT 042.0018804) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A103488) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2025-09-25 |