| NPI | 1194773523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA G87066) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA G87066) |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: CA G87066) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2022-01-04 |