NPI | 1801058821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: MS 20677) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN#12298) |
Enumeration Date | 2008-06-30 |
Last Update Date | 2011-10-24 |