NPI | 1104068972 |
---|---|
Former Name | MICHAEL LOUIS GARCIA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: GA 071501) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-03-25 |
Last Update Date | 2016-07-12 |