| NPI | 1821499344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA10152100) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 283356) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2022-07-21 |