| NPI | 1174731095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A114240) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.008784) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2016-01-04 |