| NPI | 1306856828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME101574) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 159) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME101574) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-12-30 |