| NPI | 1528270030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX T8844) |
| Additional Taxonomies | 208800000X Urology (Licence: KY 47057) |
| 208800000X Urology (Licence: WA MD60284240) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2024-09-11 |