| NPI | 1740444389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0055559) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT193767) |
| 207T00000X Neurological Surgery (Licence: PA MT193767) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2025-11-12 |