| NPI | 1407235211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2024-02169) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD470182) |
| 208800000X Urology (Licence: GA 89887) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2025-06-06 |