| NPI | 1619231321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2022-00642) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A172162) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2022-09-30 |