| NPI | 1942637095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 34862) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.022638) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2025-05-28 |