| NPI | 1295268506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA12178400) |
| 207T00000X Neurological Surgery (Licence: NY 300637) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-04-17 |