| NPI | 1427083674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD61575451) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 026386) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2025-02-06 |