| NPI | 1962664409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA C55845) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 30616) |
| 208800000X Urology (Licence: PA MD424755) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2022-05-31 |