| NPI | 1952510372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: VT 042-0015288) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT190613) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2021-08-09 |