| NPI | 1417391012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD203402) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.139474) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2021-09-03 |