| NPI | 1487845772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.083892) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME184037) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2026-08-28 |