| NPI | 1679077101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AL MD.51880) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 11420231-1205) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-11-24 |