| NPI | 1437400470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME117119) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.098757) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2015-03-27 |