| NPI | 1265669584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P2370) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 67410-20) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2026-01-22 |