| NPI | 1629290697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.085171) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N5615) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-01-25 |