| NPI | 1760491492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2016-02302) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 29189) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-03-07 |