| NPI | 1043716327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0071325) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 65882) |
| 208800000X Urology (Licence: MN 29585) | |
| 208600000X Surgery (Licence: MN 29585) | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-12-11 |