| NPI | 1376982124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 82881) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2017-02525) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2024-04-30 |