| NPI | 1538363577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX T1589) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 51002) |
| 208800000X Urology (Licence: FL ME121617) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2023-11-29 |