| NPI | 1790170249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA A171874) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125067090) |
| 208800000X Urology (Licence: IL 125067090) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2021-07-21 |