| NPI | 1841853058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A182219) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD61538564) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2025-07-02 |