| NPI | 1275995524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0073983) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A152174) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-02-20 |