| NPI | 1356497275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD00024585) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00024585) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-06-17 |