| NPI | 1598778060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR OR MD13621) |
| Additional Taxonomies | 208800000X Urology (Licence: WA WA MD00034634) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-11 |