| NPI | 1770752891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.091867) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 52597) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2017-02-06 |