| NPI | 1487654737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX G8161) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR.0028817) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2024-09-17 |