| NPI | 1841586120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101260729) |
| Additional Taxonomies | 208800000X Urology (Licence: ID M-16961) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2023-02-08 |