| NPI | 1417341538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA10870600) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA10870600) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-01-09 |