| NPI | 1578510954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2005013024) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E4587) |
| 207T00000X Neurological Surgery (Licence: OH 82517) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2021-09-30 |