| NPI | 1447540935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 91102) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2016-02525) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2026-01-08 |