| NPI | 1326225301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.086048) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301089863) |
| 208800000X Urology (Licence: LA MD.205910) | |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2022-01-25 |