| NPI | 1649280793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 080172) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301055819) |
| 208800000X Urology (Licence: VT 042.0012584) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2025-07-30 |