| NPI | 1811303787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301505866) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 5315229424) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2023-03-20 |