| NPI | 1487482667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ZZ 118493) |
| Additional Taxonomies | 208800000X Urology (Licence: DC MTR600002277) |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2025-06-25 |