| NPI | 1013294941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60620802) |
| Additional Taxonomies | 208800000X Urology (Licence: PW MD182192) |
| Enumeration Date | 2011-11-06 |
| Last Update Date | 2022-07-21 |