NPI | 1235403130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: IL 036.136881) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.136881) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-02-24 |
Last Update Date | 2023-11-30 |