| NPI | 1053816900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD484830) |
| Additional Taxonomies | 208800000X Urology (Licence: TN 1053816900) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-06-06 |