| NPI | 1396747218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 73109) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 284220) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2025-12-08 |