| NPI | 1750608527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2017-01173) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 20A14445) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2022-04-07 |