| NPI | 1225456403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DC MD045634) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101275884) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-12-13 |