| NPI | 1538164231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301044366) |
| Additional Taxonomies | 208800000X Urology (Licence: ND 13819) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-04-11 |