| NPI | 1669822136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MA 286787) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2016019196) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2021-07-26 |