| NPI | 1194947879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N8485) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 87550) |
| 207T00000X Neurological Surgery (Licence: IA 38482) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-10-21 |