| NPI | 1013393305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 101061) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 71102) |
| 207T00000X Neurological Surgery (Licence: IL 036165808) | |
| 207T00000X Neurological Surgery (Licence: IL 125.069637) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2025-12-04 |