| NPI | 1487066411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AL MD.38395) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL MD.38395) |
| 208600000X Surgery (Licence: MS T-2797) | |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2022-08-08 |