| NPI | 1457083743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101283602) |
| Additional Taxonomies | 208800000X Urology (Licence: NY P114715) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2024-08-19 |