| NPI | 1073932091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.1396815) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A162397) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2022-01-25 |