| NPI | 1487629762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IA 38061) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35-08-5970-B) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2012-07-19 |