| NPI | 1861807174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 125065866) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 76808-21) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-04-23 |