| NPI | 1639391055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2010021885) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 04-34458) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-04-12 |