| NPI | 1376961987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD73163) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX T0939) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2025-02-24 |