| NPI | 1316571623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 94-10221) |
| Additional Taxonomies | 2088P0231X (Licence: KS 94-10221) |
| 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: KS 94-10221) | |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-05-20 |