| NPI | 1508093428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301503904) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2016-02247) |
| 208800000X Urology (Licence: VA 0101248101) | |
| 208800000X Urology (Licence: CA 137309) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2024-02-05 |