| NPI | 1295736940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN 867084) |
| Additional Taxonomies | 208800000X Urology (Licence: GA 94865) |
| 208800000X Urology (Licence: KY C4408) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2025-10-16 |