| NPI | 1962446476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 34030-020) |
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: WI 34030) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-09-23 |