| NPI | 1497147144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A192343) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 57.245767) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2024-02-23 |