| NPI | 1568142958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 86998-875) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 13442471-1252) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2026-03-19 |