| NPI | 1225955347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PR 439-E) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 439-E) |
| Enumeration Date | 2026-06-30 |
| Last Update Date | 2026-07-01 |