| NPI | 1053859041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A171098) |
| Additional Taxonomies | 208800000X Urology (Licence: CA F476) |
| 208800000X Urology (Licence: FL TRN29478) | |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2023-06-14 |