| NPI | 1770515959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301089581) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD427930) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-05-19 |