| NPI | 1780632679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35061054t) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD432685) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-09-28 |