| NPI | 1871886622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: TX U8059) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 52544) |
| 208800000X Urology (Licence: PA MT199237) | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2024-02-08 |