| NPI | 1497956403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 206668) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN9839) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2018-11-06 |