| NPI | 1225962855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 14278973-1252) |
| Additional Taxonomies | 284300000X Special Hospital (Licence: UT 14278973-1252) |
| Enumeration Date | 2026-06-09 |
| Last Update Date | 2026-06-09 |