| NPI | 1821356395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35134070) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101280701) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2023-12-11 |