| NPI | 1407389372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 76556) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 74238) |
| 207T00000X Neurological Surgery (Licence: FL 74238) | |
| 207T00000X Neurological Surgery (Licence: UT 13344916-1205) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2025-04-14 |