| NPI | 1992951586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D077463) |
| Additional Taxonomies | 208800000X Urology (Licence: WV 30321) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2021-04-06 |