| NPI | 1518302017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101268724) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY R3256) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2020-06-03 |