| NPI | 1043879323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ND 20821) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4351044471) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-06-24 |