| NPI | 1740578632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 006938) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 5101019139) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2020-03-30 |