| NPI | 1558686113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0062632) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX R5839) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2021-05-27 |