| NPI | 1255324232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.078902) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD053429L) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2023-02-02 |