| NPI | 1063702538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0069938) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 82404) |
| 208800000X Urology (Licence: TN 53909) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2022-12-05 |