| NPI | 1407016082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0102204096) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0116020696) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2026-03-13 |