| NPI | 1235395849 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60546371) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125055496) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2021-05-25 |