| NPI | 1184117038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: UT 5586899-1204) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125.072925) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2026-01-15 |