| NPI | 1366478646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 242296) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD213350) |
| 207T00000X Neurological Surgery (Licence: TX S6537) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2026-05-06 |