| NPI | 1760524979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NM MD2024-1277) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G46537) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2025-01-31 |