| NPI | 1497389142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2024-02754) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101286931) |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2025-08-20 |