| NPI | 1073697173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35131450) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD36289) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-11-14 |