| NPI | 1386898419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 50454) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA MD.200794) |
| 207T00000X Neurological Surgery (Licence: AZ 50454) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2019-11-04 |