| NPI | 1255786505 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.150999) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D97385) | 
| Enumeration Date | 2016-04-24 | 
| Last Update Date | 2024-06-25 |