| NPI | 1174818850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DE C1-0013404) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD464452) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2025-09-30 |