| NPI | 1033386909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME134977) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.096922) |
| Enumeration Date | 2008-05-10 |
| Last Update Date | 2018-04-18 |