| NPI | 1851748834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 69064) |
| Additional Taxonomies | 208800000X Urology (Licence: OK 32335) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2021-06-18 |