| NPI | 1700830833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME138199) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.094337) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-05-24 |