| NPI | 1831516251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 009921) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 20A18644) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2026-05-20 |