| NPI | 1689737074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D0076696) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35095700) |
| 207T00000X Neurological Surgery (Licence: MA 239160) | |
| 207T00000X Neurological Surgery (Licence: PA MD424942) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2022-09-26 |