| NPI | 1215972732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SC 89687) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 48946) |
| 208800000X Urology (Licence: TN 3038) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-11-01 |