| NPI | 1669850418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 57824) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME155456) |
| 207T00000X Neurological Surgery (Licence: MN 63184) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2023-07-13 |