| NPI | 1871987701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101279375) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D0101187) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207T00000X Neurological Surgery (Licence: DC MD210011497) | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2025-07-30 |