| NPI | 1609257914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OK 38587) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018403A) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-06-09 |