| NPI | 1598123531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NC 216775) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2021-01032) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2025-06-26 |