| NPI | 1033672365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 79132) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.247219) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2026-05-26 |