| NPI | 1164657755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0066887) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301104520) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2021-08-21 |