NPI | 1962765586 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: WY 10929A) |
Additional Taxonomies | 208800000X Urology (Licence: MI 5101020010) |
Enumeration Date | 2012-06-19 |
Last Update Date | 2020-01-21 |