| NPI | 1508936592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A79874) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.151394) |
| 208800000X Urology (Licence: MT 122109) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2024-10-30 |