| NPI | 1124360979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MT 77400) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MT MED-PHYS-LIC-77400) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2022-02-28 |