| NPI | 1215159843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208800000X Urology (Licence: AL 32522) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2024-02-01 |