| NPI | 1639133788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NM MD2009-0006) |
| Additional Taxonomies | 208800000X Urology (Licence: CA G34981) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2011-05-27 |