| NPI | 1104023142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.093981) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH training license) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.093981) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-01-13 |