| NPI | 1437776424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0074626) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA ETLL-1192) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2025-02-13 |