NPI | 1760045504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: CA A202659) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-04-17 |
Last Update Date | 2025-07-31 |