| NPI | 1346417359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 34515) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.010599) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2012-07-05 |