| NPI | 1750389151 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX J1843)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX J1843)  | 
| Enumeration Date | 2005-07-08 | 
| Last Update Date | 2023-06-30 |