| NPI | 1437141009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2022-02129) |
| Additional Taxonomies | 174400000X Specialist (Licence: VT 042-0010380) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2023-04-19 |