| NPI | 1164425047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 34493) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR.0034493) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2025-08-11 |