NPI | 1619177045 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL ME18483) |
Additional Taxonomies | 208800000X Urology (Licence: FL ME18483) |
Enumeration Date | 2007-07-24 |
Last Update Date | 2007-07-24 |