| NPI | 1265402879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2018019483) |
| Additional Taxonomies | 208800000X Urology (Licence: TN MD19748) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2018-08-02 |