| NPI | 1821659632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2019018218) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 93408) |
| Enumeration Date | 2019-06-23 |
| Last Update Date | 2024-12-04 |