| NPI | 1548243199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD00049274) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A73728) |
| 208800000X Urology (Licence: OR MD28964) | |
| 208800000X Urology (Licence: ID M12316) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2014-04-29 |