| NPI | 1619404936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2024028243) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 32964) |
| 208800000X Urology (Licence: KY 56838) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2024-11-12 |