| NPI | 1801861018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.070719) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2020022525) |
| 207T00000X Neurological Surgery (Licence: KY 32158) | |
| 207T00000X Neurological Surgery (Licence: SC 35281) | |
| 207T00000X Neurological Surgery (Licence: OR MD213490) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2025-03-12 |