| NPI | 1376953729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.145644) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME125460) |
| 207X00000X Orthopaedic Surgery (Licence: NY 307553) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2022-08-24 |