| NPI | 1326674029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NE 34376) |
| Additional Taxonomies | 208800000X Urology (Licence: NE PEND) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-14 |
| Last Update Date | 2022-03-30 |