NPI | 1548291453 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 04344R) |
Additional Taxonomies | 208800000X Urology (Licence: LA 04344R) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2007-07-08 |