| NPI | 1568493773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA MD.200955) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 35967) |
| 208800000X Urology (Licence: NM MD2006-0523) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-12-15 |