| NPI | 1962494211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME91106) |
| Additional Taxonomies | 208800000X Urology (Licence: OH APP-000857284) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2025-02-15 |