| NPI | 1891759528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX M0965) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M0965) |
| 2085N0700X Radiology Neuroradiology (Licence: TX M0965) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2025-04-15 |