| NPI | 1942521125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 261364) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-244074) |
| 208800000X Urology (Licence: PA MD459807) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2025-07-25 |