| NPI | 1275533911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX j0142) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: HI MD-24591) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2025-05-29 |