| NPI | 1912213687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A159685) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57020192) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2023-03-14 |