| NPI | 1386146769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 0101269085) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101269085) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2025-01-31 |