| NPI | 1013125913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME138176) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.009925) |
| 207T00000X Neurological Surgery (Licence: MO 2020040602) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-01-03 |