| NPI | 1285996140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2019-01495) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2012018704) |
| 208800000X Urology (Licence: MO 2012018704) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2019-06-21 |