| NPI | 1316528995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208800000X Urology (Licence: CA 10350) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2023-05-09 |