| NPI | 1306157185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WU0100X Registered Nurse, Urology (Licence: TX S1517) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 292120) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2024-11-01 |