| NPI | 1275244006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX U1388) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX pending) |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2023-02-17 |