NPI | 1902123128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 109069) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207T00000X Neurological Surgery (Licence: GA 77695) | |
Enumeration Date | 2010-04-27 |
Last Update Date | 2017-04-18 |