| NPI | 1174590962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35085008) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301084746) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2015-09-17 |