| NPI | 1215965033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 200300066) |
| Additional Taxonomies | 208800000X Urology (Licence: TN 74329) |
| 208800000X Urology (Licence: MT 130233) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-09-30 |