| NPI | 1851604367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PR 20570) |
| Additional Taxonomies | 208600000X Surgery (Licence: PR 12678-I) |
| 208800000X Urology (Licence: TX R7586) | |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2021-02-19 |