| NPI | 1417191875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX H5696) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX H5696) |
| 208800000X Urology (Licence: TX 000000000) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2021-12-02 |