| NPI | 1578583829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2018-02609) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME0095219) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-01-30 |