| NPI | 1821656661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 61692) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ R77259) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2021-02-18 |