| NPI | 1861804098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0102207781) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2019012295) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2023-08-30 |