| NPI | 1053334318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME95815) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL me 95815) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2026-04-30 |