| NPI | 1881012391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 85193) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD60929793) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2022-06-07 |