| NPI | 1366540486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 229029) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MA 229029) |
| 208800000X Urology (Licence: MA 229029) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-04-22 |