| NPI | 1730458316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 036166214) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055344) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2023-08-01 |