| NPI | 1356874317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301509333) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A176807) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2025-06-04 |