| NPI | 1275849143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 201802346) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 125.051663) |
| 2088P0231X (Licence: IL 125.051663) | |
| Enumeration Date | 2010-08-29 |
| Last Update Date | 2021-04-01 |