| NPI | 1265453617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX K8850) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K8850) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-03-18 |