| NPI | 1568690477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 81713) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 100503) |
| 207T00000X Neurological Surgery (Licence: MN 53091) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2025-06-03 |