| NPI | 1033573274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NM MD2021-0007) |
| Additional Taxonomies | 208800000X Urology (Licence: TX S9311) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10056087) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2023-11-20 |