NPI | 1215556204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: MN 79734) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046778) |
208800000X Urology (Licence: WI 85969-20) | |
Enumeration Date | 2020-04-10 |
Last Update Date | 2025-09-11 |