| NPI | 1831474618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND 18035) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301104382) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2022-07-13 |