| NPI | 1164485041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 059605) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35079749b) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2018-10-15 |