| NPI | 1114514239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NE 10075) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 1114514239) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2026-05-21 |