| NPI | 1720421886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME161685) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101277622) |
| 208800000X Urology (Licence: GA 94925) | |
| 208800000X Urology (Licence: TN 61671) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2025-07-17 |