| NPI | 1053517359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AL MD.53288) |
| Additional Taxonomies | 208800000X Urology (Licence: TN 48132) |
| 208600000X Surgery (Licence: OK 25735) | |
| 208800000X Urology (Licence: SC 18662) | |
| 208800000X Urology (Licence: KY 48421) | |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2026-07-22 |