| NPI | 1639598972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR0072496) |
| Additional Taxonomies | 208800000X Urology (Licence: NM MD2019-0913) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-06-10 |