| NPI | 1942307467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 51361) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2015031997) |
| 208800000X Urology (Licence: FL ME96501) | |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2026-03-30 |