| NPI | 1447645304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 202103769) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A170568) |
| 208800000X Urology (Licence: IL 036158975) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-09-09 |