| NPI | 1306078183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.141180) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD457463) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2021-03-08 |