| NPI | 1962908368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 275550) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0077598) |
| 207T00000X Neurological Surgery (Licence: AZ 75480) | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2026-07-13 |