| NPI | 1942564695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35143099) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX S0592) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2021-11-05 |