| NPI | 1346583176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A161053) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME150237) |
| 208800000X Urology (Licence: WA ML.60370878) | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2023-02-14 |