| NPI | 1154350155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A064860) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35-082776) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2013-08-13 |