| NPI | 1538371422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX P9377) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 55674) |
| 208800000X Urology (Licence: MN 106121) | |
| 208800000X Urology (Licence: NE TEP) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2024-04-05 |