| NPI | 1639377245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX R7659) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: VA 0116018708) |
| 208800000X Urology (Licence: WI 3128) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2023-12-29 |