| NPI | 1770763740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A105069) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD486712) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2025-06-25 |