| NPI | 1003173956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 96068) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.145270) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2023-08-13 |