| NPI | 1730155094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN MD52511) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A83740) |
| 208800000X Urology (Licence: KY 40836) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2018-11-09 |