| NPI | 1225560907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A163502) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD61410080) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2025-02-07 |