| NPI | 1659400984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA A99841) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 5414435-1205) |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2023-08-04 |