| NPI | 1619111853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA 60633008) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 036164832) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2024-02-16 |