| NPI | 1386955870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60615492) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301096987) |
| 208800000X Urology (Licence: CA A132927) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2021-06-29 |