| NPI | 1831354810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 47163) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208800000X Urology (Licence: MN 51942) | |
| Enumeration Date | 2008-07-19 |
| Last Update Date | 2024-12-03 |