| NPI | 1720007099 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: NH EL09256) | 
| Additional Taxonomies | 208800000X Urology (Licence: NH LT4309) | 
| 208800000X Urology (Licence: NC 200000981) | |
| Enumeration Date | 2006-07-18 | 
| Last Update Date | 2022-06-16 |