NPI | 1912310442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: ME DO3032) |
Additional Taxonomies | 208800000X Urology (Licence: SC 82201) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT015640) | |
Enumeration Date | 2014-06-02 |
Last Update Date | 2020-08-02 |