| NPI | 1427457480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35144794) |
| Additional Taxonomies | 208800000X Urology (Licence: IN 01083956A) |
| 208800000X Urology (Licence: IL 036154549) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301106911) | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2022-09-01 |