| NPI | 1508817362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2012-00867) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 35523) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2022-07-21 |