| NPI | 1710993381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q0224) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D0102167) |
| 207T00000X Neurological Surgery (Licence: CT 023954) | |
| 207T00000X Neurological Surgery (Licence: DE c1-0028216) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-08-08 |