| NPI | 1689637597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0031101) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35080064D) |
| 208800000X Urology (Licence: OH 35-080064) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2021-06-14 |