| NPI | 1285161455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A175869) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT213204) |
| 208800000X Urology (Licence: PA MT213204) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-07-05 |