| NPI | 1083885644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 101540) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2019-02447) |
| 208800000X Urology (Licence: MT 158211) | |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2025-04-14 |