| NPI | 1295732980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C53377) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35075732) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-10-27 |