| NPI | 1508246448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.141169) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2020015511) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-01-26 |