| NPI | 1306343397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 62008) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A200569) |
| 207T00000X Neurological Surgery (Licence: OH 35.155714) | |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2026-06-22 |