| NPI | 1508851106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.075004) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35.075004) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2021-01-14 |