| NPI | 1306478466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ID 1271357) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR.0075039) |
| 208800000X Urology (Licence: UT 12400317-1205) | |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2025-07-16 |