| NPI | 1598471757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 73480) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL TRN36605) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-02-24 |