| NPI | 1760569933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 036.120110) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 237178) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-10-16 |