| NPI | 1891841334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD152450) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD60170081) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2022-02-04 |