| NPI | 1861751117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX R2728) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10043030) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2024-01-02 |