| NPI | 1760779458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35133214) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.059643) |
| 208800000X Urology (Licence: IN 01078386A) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2022-01-07 |