| NPI | 1114312808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101273170) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D0092538) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-01-30 |