| NPI | 1013379643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301512120) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.145307) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-07-31 |