| NPI | 1215171897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T7559) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.015920) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2022-06-06 |