| NPI | 1154702033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX S7756) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2015018554) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-07-20 |