| NPI | 1891177226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2022022257) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2015019336) |
| 208800000X Urology (Licence: CA A168832) | |
| 208800000X Urology (Licence: KS 0446304) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2022-09-06 |