| NPI | 1639600158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D0093786) |
| Additional Taxonomies | 208800000X Urology (Licence: NH 31000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2024-06-17 |