| NPI | 1407071665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 11060885-1205) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2013022993) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2022-01-26 |