| NPI | 1003115270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX S3298) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207T00000X Neurological Surgery (Licence: WA MD60827991) | |
| Enumeration Date | 2011-03-27 |
| Last Update Date | 2023-08-14 |