| NPI | 1336521764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2020015781) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2015017261) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2023-10-31 |