| NPI | 1760826952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AL 41951) |
| Additional Taxonomies | 208800000X Urology (Licence: TX R7857) |
| 208800000X Urology (Licence: GA 83291) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2024-07-11 |