| NPI | 1174568570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY FL054) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS FL054) |
| 207T00000X Neurological Surgery (Licence: OH 35.083066) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2019-08-09 |