| NPI | 1730479817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ME MD22908) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 10785181-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2019-08-06 |