| NPI | 1073593638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD00028526) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID m8215) |
| 208800000X Urology (Licence: MT 109260) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-12-22 |