| NPI | 1801167895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 292928) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 036.139458) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2018-06-07 |