| NPI | 1346566643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 289241) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 62267) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2023-06-30 |