| NPI | 1023248911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.096476) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME162510) |
| 208800000X Urology (Licence: FL HSE10865) | |
| 208800000X Urology (Licence: AR E06271) | |
| Enumeration Date | 2009-07-26 |
| Last Update Date | 2023-09-28 |