| NPI | 1386215119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND 22895) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: ND 17563) |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2025-11-20 |