| NPI | 1215989546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD00030361) |
| Additional Taxonomies | 208800000X Urology (Licence: NV 17336) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-06-22 |