| NPI | 1548472343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ME MD19703) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VT 060-0003401) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2013-09-05 |