| NPI | 1093006090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 78639) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2015-02517) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2022-07-21 |