| NPI | 1346391653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX S7326) |
| Additional Taxonomies | 208800000X Urology (Licence: MD AJ4147357) |
| 208800000X Urology (Licence: MA 245650) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2025-08-06 |