| NPI | 1699778787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0070126) |
| Additional Taxonomies | 208800000X Urology (Licence: NE 20742) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2023-10-10 |