| NPI | 1720508203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 011833) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 5101027595) |
| 207T00000X Neurological Surgery (Licence: FL OS20890) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2025-07-10 |