| NPI | 1285680306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WY 9048A) |
| Additional Taxonomies | 208800000X Urology (Licence: OK 35652) |
| 208800000X Urology (Licence: CO 30088) | |
| 208800000X Urology (Licence: MT 114117) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2023-02-14 |