| NPI | 1902148158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IL 036155600) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35139040) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2022-10-17 |