| NPI | 1528329547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301502265) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 252394) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2026-06-18 |