| NPI | 1780241380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME148217) |
| Additional Taxonomies | 208800000X Urology (Licence: FL TRN29245) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2025-03-12 |