| NPI | 1649203654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA 023262) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 13992116-1205) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2024-07-23 |