| NPI | 1720158553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0073899) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 96-00716) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2025-02-04 |