| NPI | 1053411579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 47844) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35076198) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2020-09-22 |