| NPI | 1255385258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 65999-20) |
| Additional Taxonomies | 208800000X Urology (Licence: MA 248468) |
| 208800000X Urology (Licence: AK AK6700892) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2022-07-21 |