| NPI | 1932785516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125-078554) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-078554) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2022-05-09 |