| NPI | 1194830091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101249368) |
| Additional Taxonomies | 208800000X Urology (Licence: TX M9232) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-08-09 |