| NPI | 1851494983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.140739) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 29374) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-11-19 |