| NPI | 1396065223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ID M-16528) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD61561040) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2024-07-20 |