| NPI | 1376717496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A135399) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.120005) |
| 207T00000X Neurological Surgery (Licence: MT 14003) | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2023-12-12 |