NPI | 1306360474 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: NY 322498) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 25744) |
Enumeration Date | 2017-08-01 |
Last Update Date | 2023-06-07 |