| NPI | 1235249509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 8638628-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA ML20008532) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-10-19 |