| NPI | 1588694327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35062072) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 28422) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2016-05-11 |