NPI | 1942612536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: CO DR.0070061) |
Additional Taxonomies | 208800000X Urology (Licence: KY 54765) |
208D00000X General Practice (Licence: VA 0101260413) | |
Enumeration Date | 2014-05-29 |
Last Update Date | 2023-07-25 |