| NPI | 1487034146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA OS020596) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2020-00420) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2024-05-29 |