| NPI | 1366977571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD484153) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 226931) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2024-10-24 |