| NPI | 1205032000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301090616) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301090616) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301090616) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2024-01-05 |