| NPI | 1699810507 |
|---|---|
| Other Name | LESLIE TRAVIS BULLOCK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2007030776) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036113441) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2023-04-06 |