| NPI | 1306171608 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 36195) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125053302) | 
| Enumeration Date | 2009-10-05 | 
| Last Update Date | 2021-04-30 |