| NPI | 1760222814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 80273) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 34379) |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2025-09-17 |