| NPI | 1801358239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: RI MD21192) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125.073968) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2026-07-27 |