| NPI | 1912438300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KY 60169) |
| Additional Taxonomies | 208800000X Urology (Licence: CA 157050) |
| 208800000X Urology (Licence: VA 0116038432) | |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: KY 60169) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-12-19 |