| NPI | 1578083259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 5101028330) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101028330) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2026-03-19 |