| NPI | 1932384930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 41374) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.090865) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2020-05-26 |