| NPI | 1174574180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME79645) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 93110) |
| 208800000X Urology (Licence: MI 4301512412) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2025-08-04 |