| NPI | 1699880526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35143269) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD444576) |
| 207T00000X Neurological Surgery (Licence: WA ML20007025) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-12-16 |