| NPI | 1538486295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: NY 295550) |
| Additional Taxonomies | 2088P0231X (Licence: SC 40393) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208800000X Urology (Licence: NY 295550) | |
| 2088P0231X (Licence: GA 073861) | |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2019-10-22 |