| NPI | 1417394180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301506893) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 191463) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2022-09-04 |