| NPI | 1750068631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2023025972) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA NA) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2024-04-02 |