| NPI | 1225093727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D80194) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35065678L) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2019-03-13 |