| NPI | 1053136754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 125085134) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL TRN41337) |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2025-07-02 |