| NPI | 1194987263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A137836) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.014461) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2017-10-16 |