| NPI | 1396963658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AR E-12884) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2013004671) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-02-28 |