| NPI | 1083067250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 81837) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036147515) |
| 208800000X Urology (Licence: IL 036147515) | |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2023-05-30 |