NPI | 1073035515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: NY 326443) |
Additional Taxonomies | 208800000X Urology (Licence: OH 35.137219) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-07-15 |
Last Update Date | 2023-11-29 |