| NPI | 1609856269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MS 26951) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E-12839) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2026-08-06 |