| NPI | 1306838180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 34.003216) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 007874) |
| 207T00000X Neurological Surgery (Licence: PA 0S-005472-L) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2020-12-29 |