| NPI | 1679504906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2017005395) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 04-39708) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-01-15 |