| NPI | 1649633736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2022018059) |
| Additional Taxonomies | 208800000X Urology (Licence: MA 287075) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2023-06-08 |