| NPI | 1538768270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2021041325) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.137554) |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2023-08-07 |