| NPI | 1215469804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.152669) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 60378) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2025-08-05 |