| NPI | 1043213929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0038610) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 38610) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2025-06-04 |