| NPI | 1760641476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-35145) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR.0072509) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2025-08-01 |