| NPI | 1093897860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA 20A16623) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0116018955) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2018-08-06 |