| NPI | 1336588235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.139348) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 54618) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2020-09-03 |