| NPI | 1700045606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101285423) |
| Additional Taxonomies | 208800000X Urology (Licence: TX P5503) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2025-07-31 |