| NPI | 1174625693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD199584) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD00023945) |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2020-11-03 |