| NPI | 1538389200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2007-00590) |
| Additional Taxonomies | 208800000X Urology (Licence: TN 68389) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2024-09-16 |