| NPI | 1609040609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 47644) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD457377) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2025-05-08 |