NPI | 1184813123 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: FL ME114921) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN11143) |
Enumeration Date | 2007-10-16 |
Last Update Date | 2021-07-06 |