| NPI | 1639110885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301504015) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35069039) |
| 208800000X Urology (Licence: CO DR.0070051) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-08-15 |