| NPI | 1902095664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MS 23216) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS T-2057) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS T-2057) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2016-08-23 |