| NPI | 1376554360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD451924) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME115737) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207T00000X Neurological Surgery (Licence: NJ 25MA09721300) | |
| 207T00000X Neurological Surgery (Licence: NY 269662) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2017-02-24 |