| NPI | 1962487462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 13713178-1205) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 27180) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2024-10-28 |