| NPI | 1831176445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: RI MD08879) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 154762) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2026-05-18 |