| NPI | 1710333182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN 67853) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 69396) |
| 208800000X Urology (Licence: WI 21062) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2024-01-22 |