| NPI | 1699162727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2015-0339) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 65202) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-12-20 |