| NPI | 1881146926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA SPI864) |
| Additional Taxonomies | 208800000X Urology (Licence: PA LT000763) |
| 208800000X Urology (Licence: PA MD461931) | |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2025-01-08 |