| NPI | 1891788022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX K4934) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 77084) |
| 208800000X Urology (Licence: CA G50587) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2024-05-21 |