| NPI | 1154889038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 110660) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.148962) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-09 |
| Last Update Date | 2026-06-16 |