| NPI | 1386939775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2016-00018) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301098541) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2022-10-04 |