| NPI | 1205267424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DC MD500002711) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101282179) |
| 207T00000X Neurological Surgery (Licence: WA ML60564954) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2025-02-19 |