| NPI | 1194253310 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD218283) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207T00000X Neurological Surgery (Licence: OR MD218283) | |
| Enumeration Date | 2017-06-01 | 
| Last Update Date | 2024-09-12 |