| NPI | 1760667109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 63161) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.013753) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2015-06-17 |