| NPI | 1730274689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60056506) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A95892) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2009-01-20 |