| NPI | 1952537862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0057130) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 54307) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2023-04-13 |