| NPI | 1346538527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 61829) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA MD-44899) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2025-07-15 |