| NPI | 1487858742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0059222) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019588) |
| 207T00000X Neurological Surgery (Licence: LA MD.206106) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2018-02-02 |