| NPI | 1891255048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A192387) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A192387) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-11-04 |