| NPI | 1265473631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX M3605) |
| Additional Taxonomies | 208800000X Urology (Licence: PA md420258) |
| 208800000X Urology (Licence: TX m3605) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-11-01 |