| NPI | 1760594303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 061078) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2006024406) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-03-07 |