| NPI | 1720489446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME153764) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10056345) |
| 208800000X Urology (Licence: TX BP10056345) | |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2022-06-02 |