| NPI | 1316106164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: GA 19744) |
| Additional Taxonomies | 208800000X Urology (Licence: AL MD.35204) |
| 208800000X Urology (Licence: GA 80165) | |
| 208800000X Urology (Licence: TX P9285) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2020-02-26 |