| NPI | 1093326803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD486345) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207T00000X Neurological Surgery (Licence: AZ R78484) | |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2025-01-08 |