| NPI | 1396139424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME150755) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2020-02752) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2022-02-08 |