| NPI | 1750481255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 350433691) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA 035432L) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2007-07-08 |