| NPI | 1497098370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 9148352-1205) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A154472) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2026-06-02 |