| NPI | 1598151953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 23415) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 70791) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2025-07-14 |