| NPI | 1487826244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SC 92649) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35087912) |
| 208800000X Urology (Licence: GA 87574) | |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2024-09-18 |