| NPI | 1578022125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.151007) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.246960) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2025-09-30 |