| NPI | 1215267307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA 137664) |
| Additional Taxonomies | 208800000X Urology (Licence: TX BP20035707) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2021-12-01 |