| NPI | 1538668108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SC 88808) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 11405619-1205) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2023-05-31 |