| NPI | 1093783540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX L9576) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 35033) |
| 2088P0231X (Licence: TX l9576) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2024-08-29 |