| NPI | 1538778733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA 341394) |
| Additional Taxonomies | 208800000X Urology (Licence: WV 31986) |
| 208800000X Urology (Licence: MA 294778) | |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2024-06-11 |