| NPI | 1952403024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101046369) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2023-00324) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-03-24 |