| NPI | 1457874745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 77133) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R10989) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2025-06-17 |