| NPI | 1962904110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0073994) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208800000X Urology (Licence: CA A184767) | |
| Enumeration Date | 2018-03-04 |
| Last Update Date | 2025-02-12 |