| NPI | 1588825772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.128858) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301092688) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2024-10-08 |