| NPI | 1811286842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 286536) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.017327) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2018-03-17 |