| NPI | 1114308558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IN 01091519A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT208530) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2023-09-27 |