| NPI | 1326420746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 008490) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 5101021915) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2021-05-27 |