| NPI | 1336337591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN 74821) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME 129571) |
| 208800000X Urology (Licence: ND 12769) | |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2025-09-11 |