| NPI | 1871662809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 14235720-1204) |
| Additional Taxonomies | 208800000X Urology (Licence: PA os013233) |
| 208800000X Urology (Licence: OH 34.009996) | |
| 208600000X Surgery (Licence: PA os013233) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2026-05-20 |