| NPI | 1588868426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301105781) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 52183-20) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-06 |