| NPI | 1245296375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101275901) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2012-02004) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2022-09-19 |