| NPI | 1174636344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD16033) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD00034742) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2022-02-04 |