| NPI | 1952088643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 77248) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 323544) |
| 207T00000X Neurological Surgery (Licence: OH 35.156792) | |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2026-09-23 |