| NPI | 1679541528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX S6290) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A76179) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2025-01-20 |