| NPI | 1548243009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35-075494) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 43113) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2023-04-12 |