| NPI | 1134851082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME162217) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 0009024) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2023-07-13 |