| NPI | 1114199791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101267159) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH AC2895437-T57) |
| 207T00000X Neurological Surgery (Licence: PA MD448438) | |
| 207T00000X Neurological Surgery (Licence: OH 35.093725) | |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2022-01-04 |