| NPI | 1538517164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2022-03260) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 314140) |
| 208600000X Surgery (Licence: MA 267005) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2024-02-09 |