| NPI | 1528446465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA T295325) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207T00000X Neurological Surgery (Licence: RI MD18330) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2022-11-07 |