| NPI | 1285867473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-41363) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2018031838) |
| 208800000X Urology (Licence: CO 48148) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2020-12-02 |