| NPI | 1043730112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: RI MD19639) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 272675) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2024-06-14 |