| NPI | 1497982110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: SC 83812) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301094191) |
| 2088P0231X (Licence: NH 17727) | |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2020-06-08 |