| NPI | 1174718399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A104448) |
| Additional Taxonomies | 208800000X Urology (Licence: TN MD48762) |
| 208800000X Urology (Licence: IA MD-46040) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2019-11-15 |