| NPI | 1538364914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD422781) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35089132) |
| 207T00000X Neurological Surgery (Licence: WV MD20977) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-03-07 |