| NPI | 1679708705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA A113515) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A113515) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2024-03-13 |