| NPI | 1164764445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME142998) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 33705) |
| 207T00000X Neurological Surgery (Licence: AL 33705) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-09-15 |