| NPI | 1801275128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 60660) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 100227) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: MN 60660) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2023-03-02 |