| NPI | 1760936157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 304094) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D0106455) |
| 207T00000X Neurological Surgery (Licence: CA A134741) | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2026-05-03 |