| NPI | 1568039956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME159296) |
| Additional Taxonomies | 208800000X Urology (Licence: FL 33275) |
| 208800000X Urology (Licence: FL TRN33275) | |
| Enumeration Date | 2021-06-05 |
| Last Update Date | 2023-02-13 |