| NPI | 1356630818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.120370) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 10277910) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2018-06-20 |