| NPI | 1497294375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 334474) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 304539) |
| 2085N0700X Radiology, Neuroradiology (Licence: LA 334474) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: LA 334474) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2022-12-12 |