| NPI | 1093259368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 296753) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 296753) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2022-10-11 |