| NPI | 1497389142 |
|---|---|
| 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: NC 2024-02754) |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2025-01-01 |