| NPI | 1518187384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35090672) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301075848) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-08-23 |