| NPI | 1568812436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX U4532) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 80031) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2025-07-12 |