| NPI | 1770080368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology Female Pelvic Medicine and Reconstructive Surgery (Licence: CA A186651) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-06-16 |