| NPI | 1629309588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: TX BP20029578) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A121212) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2021-12-01 |