| NPI | 1952317554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 93638) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.089123) |
| 207T00000X Neurological Surgery (Licence: FL MFC1565) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-11-29 |