| NPI | 1275758039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 96060) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 59933) |
| 207T00000X Neurological Surgery (Licence: CO DR-46397) | |
| 207T00000X Neurological Surgery (Licence: OH 57002649) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2026-01-19 |