| NPI | 1053798843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.147631) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301106996) |
| 207T00000X Neurological Surgery (Licence: MD D92961) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2023-06-23 |