| NPI | 1134124035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101236633) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101236633) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-10-21 |