| NPI | 1710147541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NH 16679) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY AB 1876296x05) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2023-04-18 |