| NPI | 1932336203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CO 0061398) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101248205) |
| 208800000X Urology (Licence: GA 75616) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2024-08-15 |