| NPI | 1730127390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX M6520) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MT 19280) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2025-07-18 |