| NPI | 1700846656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME144367) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 9500670) |
| 208800000X Urology (Licence: SC 17208) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-07-10 |