| NPI | 1316154594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND 13718) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.012189) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2017-05-05 |