| NPI | 1306073457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A154304) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: HI MD-23719) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2026-01-30 |