| NPI | 1740607795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NE 36911) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX T5541) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2026-06-10 |