| NPI | 1316935638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SD 9355) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD13162) |
| 208800000X Urology (Licence: SD 1459) | |
| 208800000X Urology (Licence: ND LT19814) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2023-06-15 |