| NPI | 1225423957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A151022) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 284556) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 21048) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2018-03-17 |