| NPI | 1235232745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD00029130) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00029130) |
| 208800000X Urology (Licence: AK 212404) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2024-05-29 |