| NPI | 1275533481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA C52122) |
| Additional Taxonomies | 208800000X Urology (Licence: TN 43255) |
| 208800000X Urology (Licence: NY 140962) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2023-08-08 |