| NPI | 1083238000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T4213) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.139021) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2025-02-24 |