| NPI | 1164751947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101261106) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.017008) |
| 207T00000X Neurological Surgery (Licence: OH 35.098448) | |
| 207T00000X Neurological Surgery (Licence: FL ME153822) | |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2022-01-31 |