| NPI | 1801842539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX F9875) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2000169370) |
| 208800000X Urology (Licence: OK 28735) | |
| 208800000X Urology (Licence: GA 072336) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-11-15 |