| NPI | 1174781587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.098223) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA 38343) |
| 207T00000X Neurological Surgery (Licence: OH 57.007381) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2022-01-05 |