| NPI | 1619239142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 51146) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ R73272) |
| 207T00000X Neurological Surgery (Licence: IA MD-45705) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2025-07-23 |