| NPI | 1568628170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND 14195) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 282403) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2023-06-27 |