| NPI | 1730530502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2020-04205) |
| Additional Taxonomies | 208800000X Urology (Licence: SC LL39777) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2023-03-20 |