| NPI | 1164721338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IA MD-44151) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR0062739) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-27 |
| Last Update Date | 2024-02-27 |