| NPI | 1518487743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 59196) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IN 01095907A) |
| 207T00000X Neurological Surgery (Licence: OH 35.148493) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.030344) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-08-05 |