| NPI | 1962571398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KY 58258) |
| Additional Taxonomies | 208800000X Urology (Licence: LA 05700R) |
| 208800000X Urology (Licence: KY TP564) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2023-07-07 |