| NPI | 1841782307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2023012283) |
| Additional Taxonomies | 208800000X Urology (Licence: OK 390200000X) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2023-08-07 |