| NPI | 1841495769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2013-01419) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101270917) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2026-04-10 |