| NPI | 1164447520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VT 042-0009377) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 338296) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2026-03-24 |