| NPI | 1033308564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2019-01218) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.122041) |
| 207T00000X Neurological Surgery (Licence: PA MD451261) | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2020-10-26 |