| NPI | 1427376425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME163757) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2018016011) |
| 208600000X Surgery (Licence: MO 2018016011) | |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2024-01-04 |