| NPI | 1164458782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101256473) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2012009848) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-06-02 |