| NPI | 1174721823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD461368) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.006078) |
| 207T00000X Neurological Surgery (Licence: OH 35-090780) | |
| Enumeration Date | 2007-07-04 |
| Last Update Date | 2019-07-16 |