| NPI | 1043655525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A168921) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR.0060248) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2020-09-02 |