| NPI | 1902040827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T1151) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 50426) |
| 207T00000X Neurological Surgery (Licence: KY TP763) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2021-12-31 |