| NPI | 1699799577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35144582) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO 41415) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-12-30 |