NPI | 1093712960 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: GA 027788) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 027788) |
Enumeration Date | 2005-07-06 |
Last Update Date | 2023-03-07 |