| NPI | 1669908422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301507855) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R76277) |
| 208600000X Surgery (Licence: AZ 57560) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-06-27 |