| NPI | 1649200023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL me80500) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301512961) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-11-21 |