| NPI | 1508200346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD199355) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD60938545) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2020-09-14 |