| NPI | 1831354810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 47163) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 51942) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-19 |
| Last Update Date | 2013-07-03 |