| NPI | 1376101691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A206548) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS 9409943) |
| Enumeration Date | 2019-06-01 |
| Last Update Date | 2026-08-12 |