| NPI | 1417027061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 00A337030) |
| Additional Taxonomies | 208800000X Urology (Licence: CA 00A337030) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2025-09-11 |