NPI | 1326433756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: LA 322013) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-02 |
Last Update Date | 2020-07-08 |