| NPI | 1194046201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101257272) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 45785) |
| 207T00000X Neurological Surgery (Licence: OH 35.120400) | |
| Enumeration Date | 2010-06-13 |
| Last Update Date | 2015-12-29 |