| NPI | 1861923286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2025037618) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 82947) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-09-03 |