| NPI | 1396107710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX V0766) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125073300) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2024-11-21 |