| NPI | 1659865681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 62058) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.150935) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2026-06-30 |