| NPI | 1548205362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA MD.023649) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA R#056216) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2025-03-25 |