| NPI | 1558715839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX U3573) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA Pending) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-05-16 |