| NPI | 1336709625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2024031103) |
| Additional Taxonomies | 208800000X Urology (Licence: TX BP10068816) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-08-12 |