| NPI | 1225370521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2026-00444) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 55568) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207T00000X Neurological Surgery (Licence: IL 125063152) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2026-04-22 |