| NPI | 1114008364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2021-02745) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35126531) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-11-03 |