| NPI | 1518067339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD154094) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00044697) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2021-10-13 |