| NPI | 1417256488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A141990) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-057834) |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2016-05-03 |