| NPI | 1841529757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA A120045) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.094810) |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2016-04-01 |