| NPI | 1326664384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A199466) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2020015987) |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2025-07-01 |