| NPI | 1922165000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD434333) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT184231) |
| 208800000X Urology (Licence: CA A109939) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-06-04 |