| NPI | 1992579973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME176551) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 33918) |
| Enumeration Date | 2023-11-10 |
| Last Update Date | 2025-10-15 |