| NPI | 1174563175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA G139173) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD016982E) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-08-16 |