| NPI | 1568579688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35125071) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 036-071264) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2018-03-17 |