| NPI | 1891132437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.134479) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57.024438) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2021-01-25 |