| NPI | 1912401118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0077095) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME173553) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2026-10-01 |