| NPI | 1619331220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2022022840) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 0446242) |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2022-11-29 |