| NPI | 1710058532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A89398) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A89398) |
| 208600000X Surgery (Licence: CA A89398) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2023-11-27 |