| NPI | 1730173287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2005-00346) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 2005-00346) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2025-01-30 |