| NPI | 1104441278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.153594) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT220037) |
| Enumeration Date | 2020-06-14 |
| Last Update Date | 2025-06-23 |