| NPI | 1588921969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AL 50581) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2019-00243) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2025-01-24 |