| NPI | 1497286827 |
|---|---|
| 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: PA MD481782) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-07-28 |