| NPI | 1730322504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NH 17574) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D78158) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2020-07-10 |