| NPI | 1447754759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E-19356) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX W5945) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 64079) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2026-06-25 |