| NPI | 1245434059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 10970793-1205) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 51000) |
| 208800000X Urology (Licence: LA MD.205248) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-05-12 |