| NPI | 1013331172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ID M-16790) |
| Additional Taxonomies | 208800000X Urology (Licence: OR PG205281) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2022-08-23 |