| NPI | 1700159555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0053952) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 267037) |
| 207T00000X Neurological Surgery (Licence: GA 67516) | |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2026-05-18 |