| NPI | 1104147362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 3380-320) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 201200739) |
| 208800000X Urology (Licence: ID M-15905) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2024-01-26 |