| NPI | 1891731949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OK 35163) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35-120570) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2019-10-12 |