| NPI | 1316442775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.155658) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 61850) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2026-04-08 |