| NPI | 1003481656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OK 1003481656) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 390200000X) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2021-05-26 |