| NPI | 1568578029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD26764) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD00046362) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-01-19 |