| NPI | 1598732380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME138367) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.076722) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2024-03-05 |