| NPI | 1013228410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35133560) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60741609) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2021-01-06 |