| NPI | 1720347834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX S5658) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX BP10044112) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN28162) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2020-09-17 |