| NPI | 1316136674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 036142621) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 57013089) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2021-05-03 |