| NPI | 1053301440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD61157938) |
| Additional Taxonomies | 208800000X Urology (Licence: IN 01046851A) |
| 208800000X Urology (Licence: CA G74666) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2021-10-14 |