| NPI | 1114045358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-38869) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2012039473) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2025-06-06 |