| NPI | 1376067272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125071422) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125071422) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-07-21 |