| NPI | 1972794014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2016-00022) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101251410) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 100774) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2023-09-14 |