| NPI | 1568606747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101260948) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 073884) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2025-10-17 |