| NPI | 1033524582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NE 31523) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2014018335) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2022-01-06 |