| NPI | 1588695654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX H2964) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS B29973) |
| 208800000X Urology (Licence: MS 11417) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-06-28 |