| NPI | 1760640791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 201902815) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2012010357) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2021-01-07 |