| NPI | 1235210493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD00048998) |
| Additional Taxonomies | 208800000X Urology (Licence: DC MD035545) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2026-09-09 |