| NPI | 1336133115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 30154) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 31899) |
| 208800000X Urology (Licence: LA MD.202729) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2024-01-10 |