| NPI | 1285876946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 071456) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL trn12406) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 12406) | |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2019-01-25 |