| NPI | 1861616799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A109261) |
| Additional Taxonomies | 208800000X Urology (Licence: TN AC5611000-5984) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-01-25 |