| NPI | 1316042047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: TX Q5383) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301090914) |
| 208800000X Urology (Licence: NH rt1113) | |
| 208800000X Urology (Licence: CA A121320) | |
| 208800000X Urology (Licence: CO CDR0002333) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-03-28 |