| NPI | 1003172974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.135582) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 281553) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2020-02-28 |