| NPI | 1689985822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD61523474) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101253251) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2024-09-05 |