| NPI | 1497826796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MS 25020) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 8878) |
| 208800000X Urology (Licence: ND 7039) | |
| 208800000X Urology (Licence: AL 1166) | |
| 208800000X Urology (Licence: SD 4405) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2021-09-20 |