| NPI | 1558420596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60147514) |
| Additional Taxonomies | 208800000X Urology (Licence: HI MD-10720) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2021-04-19 |