| NPI | 1134236276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AR E-4160) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101046787) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-01-22 |