| NPI | 1376021279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2025-02481) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 277153) |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2025-09-23 |