| NPI | 1306055074 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.097826) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301079619) |
| 207T00000X Neurological Surgery (Licence: GA 062513) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2019-01-03 |