| NPI | 1093448607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 13548246-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10080668) |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2023-08-22 |