| NPI | 1003813940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-39336) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2017013714) |
| 208800000X Urology (Licence: CT 041202) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-07-21 |