| NPI | 1821181553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 22784) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2022-1364) |
| 207T00000X Neurological Surgery (Licence: CA A94960) | |
| 207T00000X Neurological Surgery (Licence: OH 35.120019) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2022-01700) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2026-02-16 |