| NPI | 1942736822 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 85051) | 
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2024016280) | 
| Enumeration Date | 2017-05-11 | 
| Last Update Date | 2025-07-07 |