| NPI | 1326246638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IA MD-54163) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX S9740) |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2025-11-23 |