| NPI | 1578190799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 125.075483) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 34939) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-06-26 |