| NPI | 1922156181 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101267017) | 
| Additional Taxonomies | 208800000X Urology (Licence: NC 2011-00424) | 
| Enumeration Date | 2007-01-06 | 
| Last Update Date | 2023-07-17 |