| NPI | 1770902728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 77423) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101272059) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2025-07-08 |