| NPI | 1699295808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL OS18708) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-071360) |
| 208800000X Urology (Licence: IL 125-071360) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-09-02 |