| NPI | 1881900454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME127606) |
| Additional Taxonomies | 208800000X Urology (Licence: PR 12725) |
| 208800000X Urology (Licence: OH 35.149329) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2024-01-25 |