NPI | 1083025951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: MS 26523) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-05-14 |
Last Update Date | 2019-07-19 |