| NPI | 1508862335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA G40586) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G40586) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2015-06-12 |