| NPI | 1851352009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA C202461) |
| Additional Taxonomies | 208800000X Urology (Licence: TN MD0000037489) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2025-11-13 |