| NPI | 1750551123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 036-121092) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 223460-1) |
| 207T00000X Neurological Surgery (Licence: VA 010124245764) | |
| Enumeration Date | 2008-03-02 |
| Last Update Date | 2009-06-03 |