| NPI | 1508867474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101277306) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 9900033) |
| 208800000X Urology (Licence: SC 85325) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2023-04-13 |