| NPI | 1578534384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 5101010249) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 34012721) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-11-03 |