| NPI | 1922794403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 60-P13112101) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0009866) |
| 207T00000X Neurological Surgery (Licence: FL 34231HSE) | |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2024-09-20 |