| NPI | 1245360320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: AL AL.49915) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A98150) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2024-12-30 |