| NPI | 1225448616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35-130106) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0071446) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2023-12-14 |