| NPI | 1306840954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A26178) |
| Additional Taxonomies | 208800000X Urology (Licence: IA MD-45912) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2019-02-15 |