| NPI | 1154703072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.143854) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY R3850) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2022-01-11 |