| NPI | 1679599542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME163832) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35-042211) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-11-06 |