| NPI | 1104271980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SC 89655) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL39663) |
| 208800000X Urology (Licence: IL 036155296) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-01-16 |