| NPI | 1720166812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60407946) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A92160) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2015-10-09 |