NPI | 1326483678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: LA 312438) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208800000X Urology (Licence: MS 26807) | |
Enumeration Date | 2013-04-30 |
Last Update Date | 2019-07-31 |