| NPI | 1689729022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN MD54352) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57-012245) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2018-08-16 |