| NPI | 1639308182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.128904) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ R71670) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2016-06-29 |