| NPI | 1831242213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD00044965) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A72651) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2021-04-27 |