| NPI | 1073856399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD477100) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX S6427) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2022-08-26 |