| NPI | 1003957952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN MD59818) |
| Additional Taxonomies | 208800000X Urology (Licence: LA MD.201359) |
| 208800000X Urology (Licence: KS 9405690) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2019-09-27 |