| NPI | 1588002448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CT 076154) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A153892) |
| 208800000X Urology (Licence: NY 300130) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2023-11-13 |