| NPI | 1316262223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A111351) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD60637093) |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2023-03-14 |