| NPI | 1548277411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL OS19677) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 34009206) |
| 208800000X Urology (Licence: KY 03532) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2023-05-05 |