| NPI | 1316442874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 5101027432) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 5151010815) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-07-12 |