| NPI | 1457360901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA 72823) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N8349) |
| 2085N0700X Radiology, Neuroradiology (Licence: TX N8349) | |
| 207T00000X Neurological Surgery (Licence: OH 35.086313) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-04-14 |