| NPI | 1023428109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101266587) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 200961) |
| 208800000X Urology (Licence: NC 200961) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2020-10-28 |