| NPI | 1225117039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME132499) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 217717) |
| 207T00000X Neurological Surgery (Licence: OH 35097637) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2022-07-21 |