| NPI | 1780066696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T7171) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125.067555) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2022-10-07 |