| NPI | 1780654368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 39449-020) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.122277) |
| 207T00000X Neurological Surgery (Licence: IA 36082) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2017-10-02 |