| NPI | 1831183052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD425946) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IN 01075655A) |
| 207T00000X Neurological Surgery (Licence: OH 35052862) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2023-11-03 |