| NPI | 1326200049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA C169893) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101245980) |
| 208800000X Urology (Licence: WA MD60894515) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-09-14 |