| NPI | 1770931297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 125.068626) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX u9989) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2024-04-08 |