| NPI | 1225699408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0072903) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2019023352) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2026-06-05 |