| NPI | 1003475914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NH 20456) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2019-01263) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-07-22 |