| NPI | 1376833533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101267147) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD0000057357) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2021-07-07 |