| NPI | 1144789157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME179701) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2026-03-19 |