| NPI | 1306877667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: WV 34647) |
| Additional Taxonomies | 208800000X Urology (Licence: TX G3848) |
| 208800000X Urology (Licence: MO 2025006931) | |
| 208800000X Urology (Licence: OH 35132150) | |
| 208800000X Urology (Licence: NM 96-387) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-05-07 |