| NPI | 1538166657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN M00000035883) |
| Additional Taxonomies | 208800000X Urology (Licence: KY 34677) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2019-08-19 |