| NPI | 1942525704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN DO2774) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0060443) |
| 207T00000X Neurological Surgery (Licence: NC 2025-03646) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2025-10-24 |