| NPI | 1851704639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101281341) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125064963) |
| 208800000X Urology (Licence: NC 2019-00829) | |
| 208800000X Urology (Licence: MD D0091463) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2024-10-28 |