| NPI | 1780849539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2024037301) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E8249) |
| 207T00000X Neurological Surgery (Licence: OH 35.130725) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2025-03-24 |