| NPI | 1336155993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NM 98-37) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM 98-37) |
| 208800000X Urology (Licence: AZ 79487) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2026-05-20 |