| NPI | 1609261734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101283449) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.146429) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2024-10-08 |