| NPI | 1427036664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101059177) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 9901170) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2025-01-09 |