| NPI | 1538698543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 036160253) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT212656) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT212656) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-06-24 |