| NPI | 1316042047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX Q5383) |
| Additional Taxonomies | 208800000X Urology (Licence: CO CDR0002333) |
| 208800000X Urology (Licence: TX Q5383) | |
| 208800000X Urology (Licence: CA A121320) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2025-07-30 |