| NPI | 1275061707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX U8035) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX U8035) |
| 2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging (Licence: TX U8035) | |
| 208600000X Surgery (Licence: TX U8035) | |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2024-08-23 |