| NPI | 1710927728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301072083) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 75601) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-11-21 |