| NPI | 1144470568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A143526) |
| Additional Taxonomies | 208800000X Urology (Licence: OR MD162279) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2021-12-08 |