| NPI | 1881670164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2005-00344) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200500344) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2021-05-27 |