| NPI | 1922399583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 57746) |
| Additional Taxonomies | 208800000X Urology (Licence: ID M-16969) |
| 208600000X Surgery (Licence: WI 57746-20) | |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2023-08-06 |