| NPI | 1548689144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 21035) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125066065) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2021-11-26 |