| 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 |