| NPI | 1205101896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IN 11016161) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.133948) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2026-04-20 |